- Occurs in nearly one quarter of patients with acute ischaemic stroke
- Generally worst on day of stroke onset
- Often on the same side as the stroke lesion
- More common in posterior circulation stroke
- Stronger association with younger age, female sex, and history of migraine
- Severity is not related to the size of the stroke lesion
- There is no association between headache and outcome
Some practical points for clinical practice
- The medication Modified Release Dipyridamole is used much less now but important to enquire about it since frequently causes headache
- Movement and cough can exacerbate headache after stroke
- It is important to exclude other stroke complications which can cause headache, notably arterial dissection
- It is useful to include possible headache as a specific question on admission to the acute stroke unit to ensure it is not overlooked
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